Why go tattoo and mark-free?

Prior to Vision RT inventing Surface Guided Radiation Therapy (SGRT), drawing marks or permanently marking patients was the only option clinics had to set-up patients to ensure treatment was delivered to a precise location. For some patients’, tattoos are a painful experience and become a lifelong reminder of their cancer treatment.

AlignRT SGRT technology can eliminate the need for tattoos or additional radiation and has been shown in several studies to be at least as accurate as either marks or tattoos for positioning patients prior to treatment.¹-³ Tattoo and mark-free treatments using AlignRT have been shown in studies to be 21% faster (per fraction) than traditional methods.⁴-⁸ More than 250 clinics have now gone tattoo and mark-free with AlignRT Advance and can be found on our patient treatment locator on saferradiationtherapy.com

Patients will go out of their way to choose tattoo & mark-free

The breast journal study in 2019 surveyed 138 Young Survival Coalition Cancer patients about how they feel about permanent radiation tattoos and marks. The study reveals that patients prefer a tattoo and mark-free option. Offering this can give your center a clear point of differentiation from your competition. Vision RT has customer resources available including a patient information tool kit to help you with your marketing.

What are your overall feelings about receiving a tattoo as part of your cancer treatment?

What are your overall feelings about skin marks during your radiation therapy treatment?

Patients will spend more time and money for a tattoo and mark-free option.

Patient treatment locator

Our patient website, Safer Radiation Therapy, has a patient treatment locator, enabling patients to search for a list of centers and physicians who use AlignRT. Patients can also check which centers offer tattoo and mark-free radiation therapy.

Northside Cancer Institute uses the locator to highlight their radiation oncologists and award-winning cancer institute to patients. In 2020, more than 100 patients saw NCI on the treatment locator.

Current Radiation Oncologists who are AlignRT customers can register to be added to the locator. 

Setting a new standard of care in radiation therapy


AlignRT tracks a patient’s skin surface in real-time with sub-millimetric† accuracy.

Fully utilizing SGRT allows for the implementation of a completely markless system of simulation and treatment, thereby simultaneously improving patient satisfaction, throughput, and setup accuracy.⁴

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Protects the heart

AlignRT can help minimize radiation exposure to the heart.

The elimination of tattoos together with SGRT offers a comparable set-up for right-sided breast treatments against the traditional tattoo method. A significant set-up improvement was observed for the left-sided breast DIBH treatments.5

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Patient Experience

AlignRT can eliminate the need for permanent marks or tattoos.

Heidi Probst, Professor of Radiotherapy and Oncology discussed her experience: “Sometimes, you don’t want to have to explain to inquisitive people why you have a black dot on your chest, you just want to get on with living.”

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Reduced treatment time blocks

Tattoo and mark-free treatments reduce in-room time and treatment time blocks.

By using AlignRT for tattoo and mark-free treatment and setup times, Northside Cancer Institute produced an average reduction of in-room time by 14%, compared to setup with skin marks and tattoos.

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Hear from our users

“AlignRT has enabled us to increase patient safety and comfort, as we no longer have to tattoo and mark our patients, as we had to using traditional radiation therapy, to set patients up for daily treatment.”

Kim Kyung Su
Head of the Department of Radiation Oncology,
EWHA Woman’s University Seoul Hospital


  1. Herron E, et al. Surface guided radiation therapy as a replacement for patient marks in treatment of breast cancer. International Journal of Radiation Oncology • Biology • Physics 2018;102 (3):e492-e493.
  2. Shah AP, et al. Clinical evaluation of interfractional variations for whole breast radiotherapy using 3-dimensional surface imaging. Pract Radiat Oncol 2013;3 (1):16-25.
  3. Sueyoshi, et al. Eliminating Daily Shifts, Tattoos, and Skin Marks: Streamlining Isocenter Localization With Treatment Plan Embedded Couch Values for External Beam Radiation Therapy PRO https://doi.org/10.1016/j.prro.2018.08.011
  4. Giantsoudi PhD, et al. Tattoo Free Set-up for Breast Cancer Patients Receiving Regional Nodal Irradiation, Practical Radiation Oncology (2022), https://doi.org/10.1016/j.prro.2022.08.001
  5. Mueller et al. Accuracy and Efficiency of Patient Setup Using Surface Imaging versus Skin Tattoos for Accelerated Partial Breast Irradiation (2023), https://doi.org/10.1016/j.adro.2023.101183
  6. Sauer, TO. et al. Prerequisites for the clinical implementation of a markerless SGRT-only workflow for the treatment of breast cancer patients. Strahlenther Onkol 199, 22–29 (2023), https://doi.org/10.1007/s00066-022-01966-7
  7. Hickey et al. Surface Guided Radiotherapy (SGRT) vs Varian RPM for deep inspiration breath-hold (DIBH) breast treatments (2018-2020).
  8. Kang, S., Jin, H., Chang, J.H. et al. Evaluation of initial patient setup methods for breast cancer between surface-guided radiation therapy and laser alignment based on skin marking in the Halcyon system. Radiat Oncol 18, 60 (2023). https://doi.org/10.1186/s13014-023-02250-3
  9. Herron E, et al. Surface guided radiation therapy as a replacement for patient marks in treatment of breast cancer. International Journal of Radiation Oncology • Biology • Physics 2018;102 (3):e492-e493.
  10. Rigley, J., P. Robertson, and L. Scattergood (2020). “Radiotherapy without tattoos: Could this work?” Radiography (Lond).

Get in touch

Ready to take the next step?

Vision RT’s family of SGRT solutions guide radiation therapy for better patient care at every step: Sim, Planning, Treatment and Dose. Whether you’re looking for a quote, a product demo (virtual or in-person) or just more information, please get in touch.